In the best practice management of concussion in football, the critical element is the welfare of the player in the short and long term. These guidelines should be adhered to at all times.

Decisions regarding return to play after a concussive injury (a disturbance of brain function) should only be made by a medical officer with experience in concussive injuries.

Generally, initial decisions in this area in community football will be made by the head trainer, unless the club has a medical doctor in attendance.

Trainers should not be swayed by the opinions of players, coaching staff or others suggesting a premature return to play. Conversely, coaches must, in accordance with the AFL Coaches Code of Conduct, not put undue pressure on trainers or players to make such decisions.

A major responsibility of coaches is their duty of care towards their players and the players’ safety. This duty is highlighted when players receive a knock to the head and suffer a concussive injury.

The key components of management of concussion include:

Any player who has suffered a concussion or is suspected of having a concussion must be medically assessed as soon as possible after the injury and must not be allowed to return to play in the same game or train in the same practice session.

There should be a trained first aider (trainer with current first aid qualifications) at every game and the principles of first aid, including management of the cervical spine, should be used when dealing with any player who is unconscious or injured.

A concussed player must not be allowed to return to school or return to training or playing before having a formal medical clearance.

For children (players aged 5-17). This is a new aspect of the 2013 guidelines.

The child is not to return to play or sport until they have successfully returned to school/learning, without worsening of symptoms. Symptom assessment in the child often requires the addition of parent and/or teacher input.

It is reasonable for a child to miss a day or two of school after concussion, but extended absence is uncommon.

It is critical that the basic principles of return to play decisions are followed to ensure that a concussed player is fully recovered before being allowed to do so.

All players with concussion or suspected concussion need an urgent medical assessment (with a registered medical doctor). This assessment can be provided by a medical doctor present at the venue, local general practice or hospital emergency department.

A player with suspected concussion must be withdrawn from playing or training until fully evaluated by a medical practitioner and cleared to play.

A concussed player must not be allowed to return to school, or return to training or playing before having a medical clearance.

It is important that concussion is managed correctly and that players do not return to play or training until they are fully recovered.

These concussion guidelines have been published by the AFL as a Position Statement on the Management of Concussion in Australian Football. It is based on guidelines developed by the AFL Medical Officers’ Association which incorporate research that has been funded by the AFL Research Board and which was undertaken by Dr Michael Makdissi, Assoc Prof Paul McCrory and Assoc Prof Gavin Davis.